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 Children with disabilities are more likely to be referred to child
protective services (CPS) than children without disabilities, the
researchers say.
“What we found was that the high-risk cohort of children with
disabilities experienced future maltreatment sooner and more often
than other children,” said lead author Dr. Caroline J. Kistin of the
pediatrics department at Boston Medical Center.
“This is a high risk population that we can identify in a fairly
straightforward way so we can provide additional support,” she
added.
The researchers analyzed data from the National Child Abuse and
Neglect Data System on more than 489,000 children from 33 states,
Puerto Rico, and the District of Columbia who had first-time
unsubstantiated referrals for neglect in 2008.
While the vast majority did not have disabilities, nearly 12,600 of
the children did have conditions included in the Individuals with
Disabilities Education Act, like autism, deafness or blindness.
By 2012, 45 percent of children with disabilities had been referred
again to CPS, compared to 36 percent of those without disabilities.
Sixteen percent of those with disabilities had experienced
substantiated maltreatment and seven percent had been placed in
foster care.
Maltreatment and foster care were both more common for kids with
disabilities, the authors reported in JAMA.
There might have been more reports of maltreatment among kids with
disabilities because these kids interact more with healthcare
providers and specialists who are mandated reporters, but in any
case this seems to be a vulnerable population, the authors wrote.
“One issue is that kids with disabilities are at increased risk for
being abused or neglected and at increased risk of being identified
as abused or neglected,” said Howard Dubowitz, head of the Division
of Child Protection and director of the Center for Families at The
University of Maryland School of Medicine in Baltimore.
“We need to be really mindful that these often are particularly
vulnerable kids that need extra care,” Dubowitz, who was not part of
the new research, told Reuters Health by phone.
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Some states now approach CPS investigations focusing on what
families need, rather than finding someone at fault, which is a
better conceptual approach, he said.
“There clearly are many parents with kids who have disabilities who
do a fabulous job,” Dubowitz said.
Children commonly had multiple disabilities, including physical,
behavioral and learning issues, that made it hard to tell which
types of disabilities were the biggest risk factors, Kistin told
Reuters Health by phone.
“Given limited funds this might be a high yield population,” she
said.
Most reports to CPS are of neglect and are unsubstantiated, meaning
there’s not enough legal evidence to prove maltreatment, she said.
“Instead of expecting CPS to expand services, I think we need to
really look at other ways that other institutions can partner with
CPS,” which would include notifying pediatricians and schools of an
unsubstantiated report of neglect, Kistin said.
“As a pediatrician if there’s a report from the school system, I
might not know,” she said. “If we could recognize the fact that
(just because it’s unsubstantiated) doesn’t mean that there’s no
risk going forward, we would see this not as the end of the referral
but as opportunity for more help.”
SOURCE: http://bit.ly/1ZM2Syy JAMA, online January 5, 2016.
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